Patterns of drug prescription for Japanese cedar pollinosis using a clinical vignette questionnaire.
BACKGROUND
Although prescribed drugs directly affect patient outcome, the variation in physicians' attitudes towards drug therapy for cedar pollinosis has not been quantitatively assessed. This research investigated the prescription patterns of drugs for cedar pollinosis by ear, nose, and throat specialists (ENTs), general physicians (GPs) and internal medicine doctors (IMs) in Yamanashi Prefecture, Japan.


METHODS
A cross-sectional study was conducted by mailing questionnaires to 532 physicians in autumn 2006. The main part of the questionnaire constituted clinical vignettes of pollinosis cases with nasal and ocular symptoms ranging from mild to severe. We requested that the physicians fill out prescription medications they considered appropriate for each vignette.


RESULTS
Responses from 172 physicians (32%) for six clinical vignettes were analyzed. The number of drugs prescribed by ENTs was significantly higher than that by GPs and IMs for vignettes representing moderate to severe cases (p < 0.004). The percentage of physicians who said they would prescribe nasal corticosteroid and eye drops was higher in the ENT group compared to the other two groups in these vignettes. In terms of second-generation antihistamines, no differences were observed between the three groups for all vignettes.


CONCLUSIONS
Our investigation suggested that, compared to ENTs, GPs and IMs have a lower tendency to concomitantly prescribe drugs for localized treatment such as nasal corticosteroids and eye drops with oral medication. There may be differences in prescription patterns of drugs for pollinosis between ENTs and non-specialist physicians.
Takahashi
Goro
G
Department of Otorhinolaryngology, Yamanashi University, Yamanashi, Japan. gr-tkhs@umin.ac.jp
Matsuzaki
Zensei
Z
Nakayama
Takeo
T
Masuyama
Keisuke
K
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D032485:Cryptomeria; D005260:Female; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use; D006801:Humans; D007388:Internal Medicine / Q000706:statistics & numerical data; D007564:Japan; D008297:Male; D009883:Ophthalmic Solutions / Q000627:therapeutic use; D010036:Otolaryngology / Q000706:statistics & numerical data; D010821:Physicians, Family / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D055656:Prescriptions / Q000706:statistics & numerical data*; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy* / Q000503:physiopathology; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
D000305:Adrenal Cortex Hormones; D039563:Histamine H1 Antagonists, Non-Sedating; D009883:Ophthalmic Solutions